Ketogenic diet


Exercising at a specific heart rate will use more fat metabolism than muscle glycogen. It also won’t cause as much of a drop in your blood sugar.

The downside is that it won’t result in as much cardiac fitness.

The heart rate is aerobic. There is s formula that tells you approximately what it should be for you, based on age and fitness. I can give it to you if you are interested.


Figuring I have a lead cardiologist and a lead endocrinologist who also has Type 1 Diabetes agree that long term use of this can 1)cause DKA, 2)keto causes muscle damage which includes the heart muscle, and 3) have recently ran into a bunch of people who have had the same issues as I have it’s more common than you think. It’s one thing for a non-Diabetic to do keto (still don’t recommend it as I’m also a sports nutritionist) but over time too much weight loss by keto can do more harm than damage.


I bet he didn’t show you any trials or evidence to show this and you didn’t do much reading on it…, But keto isn’t compulsory, eat how you want to.


K, you do what works for you, and I’ll do what works for me (and many others). We all make choices about our healthcare and diet on a daily basis.

As a biologist with a PhD, I’d love to know the mechanism of “keto causes muscle damage which includes the heart muscle…” That sort of blanket, unsourced claim is dangerous, unscientific, and (at least in my educated opinion) total garbage.


I started Keto diet a week ago and am loving it. Losing 0.3-0.5 lbs per day on about 1650 calories per day. I weighed 160 when I started. Munchies are totally gone. I am “normal” hungry at meal times, but by no means starving. My BGs are incredibly good. I am able to stay below 130 most of the time. Occasional peaks around 150 if I miss on bolus amount, but I’m improving on that. I eat a 1/4 cup of nuts for morning and afternoon snacks to try to meet fat consumption. Plus is a nice snack. I used to be constantly snacking on cookies, chips etc. I do eat a couple of squares of dark chocolate each day for a treat. Only 6 carbs

Eating approx, 6% carbs, 16% protein and 78% fats. Translates to carbs: 25 / 68 / 138. Lots of olive, avocados, and nuts. Basically try to eat no carbs and then double grams of fat over protein for meals. Carbs come alon naturallly with nuts, cheese, etc. For breakfast, I eat a protein shake with with 2 Tbsp chia seeds and 1 Tbsp olive oil to get started against the high fat gram quota.

My Endocronologist will be quite happy with weight and BG control. Historically my A1c has run between 7.1-7.8. Expecting 7.0 or lower next test.

I’m just getting started, but am seeing lots of good recipes.


I’m interested in Keto for more control but worry about fat content because I have two very blocked arteries to my heart. I also wonder how to shoot for protein and fat…any thoughts? Thank you for bringing this to our table😊


@Kimball1 My cardiovascular surgeon and my cardiologist both know my husband and I follow a keto diet. (edited to say, lately, ketoish!) We actually need to increase the amount of fat we consume to help with the numbers, so we bought some keto mct oil pills. We just got them and haven’t tried them yet. Still, it was my cardiovascular surgeon who told us about keto, as he had gone on it himself. All of our doctors, and there are many, know we are on it, and I have severe vascular disease AND have not told us or me not to follow a keto diet, but rather have encouraged it. It’s my belief (and our physicians) that it is the carbohydrates that contribute to the plaque in our arteries and veins. Check with your cardiologist or other physicians and see what they say for you; for us, it’s more than okay. :slight_smile:

Here’s a video that I really like; you might find it helpful:


One thing I’ve learned is that dietary fat has no connection to the blood fats associated with heart disease. These fats are manufactured in the liver and their main source for producing triglycerides (fats) in the blood are carbohydrates, not dietary fats.

The notion that dietary fat fuels heart disease is called the “diet-heart hypothesis.” It has been thoroughly discredited in the last several years.

I also have coronary artery plaque in my three heart arteries and that’s caused me to do a lot of reading about this issue since my high-score coronary artery calcium scan last September.

Nutritional ketosis promotes an increased circulation of ketones in the blood. These ketones are a fuel favored by both the heart and brain. The metabolism of ketones minimizes the reactive oxygen species often associated with glucose (carbs) metabolism. Ketones have a cleaner exhaust!

My current eating style includes limiting daily carbs to < 30 grams with the complete elimination of all grains and added sugars, except for hypo treatments. My weight currently rests at 154 pounds and I eat about 50 grams of protein per day. A nominal protein target is about 0.36 grams per pound of body weight.

The most common mistake people make when pursuing a ketogenic diet is being shy about consuming enough dietary fat.


Well, I just listened to a seminar with cardiologists who sited studies about fat and low carbs making insulin resistance much, much worse and the low fat plant based diet causing less insulin resistance. These doctors definitely feel that fat is the problem.

I just wish that all these so call experts about both diets could get on the same page and come to some conclusion about which diet is healthier. The only thing that they seem to agree on is the fact that the typical American diet is harmful. I am really getting tired of their constant disagreements about what is healthy. Meanwhile each of us is left to try the
diets ourselves and choose the one which makes us feel best, and in the long run doesn’t hurt us.


Here is a partial list of some of the groups and organizations who don’t agree with you that is has been “discredited”:

  • The American Heart Association
  • The World Health Organization
  • The Dietitians of Canada
  • The British National Health Service
  • The European Food Safety Authority
  • The British Heart Foundation
  • The United States Food and Drug Administration
  • The British Dietetic Association
  • The Food and Nutrition Board of the National Academy of Medicine
  • The Heart and Stroke Foundation of Canada
  • The World Heart Federation
  • The American Dietetic Association

Every single one of these groups advises the reduction of saturated fats.


What does the American Diabetes Assosiation recommend?


Are any of these professional associations conflicted by sponsorship relationships with Big Food or Big Pharma?

I am quite comfortable with my position that’s contrary to your list of “expert” associations. The world-wide emergence of obesity, type 2 diabetes, and heart disease is, in my humble opinion, the legacy that these associations have built.


It would be nice for us to have clear and unambiguous direction at this time but the science is not fully settled yet. Plus, I think there is enough variance across the human population that some diets are better suited to certain physiologies and metabolisms.

Marilyn, while our dietary preferences are different, we do agree on some important things. Whole foods are better than processed foods, for instance. Eating a combination of high carb and high fat is likely unhealthy.

You are eating a diet that makes you feel well. That’s your body telling you that it likes your food choices. I think that’s more important than any medical study. Likewise, I am eating a diet that makes me feel well and energetic.

I don’t think there exists a single way of eating that satisfies everyone. In the meantime, we each need to do what we think is in our best interest. Does that make any sense?


Oh, I think it makes perfect sense Terry. I do think it is good though, for folks to know all the options for good healthy eating. Hopefully we will be disagreeing about our diets until we are both very, very old. :grin:


Thank you Tapestry! You make me feel less tentative about this. Still collecting info and enjoyed the video very much. I notice that on low carb when I do eat a cookie my bs skyrockets - not worth the effort needed to get me back to a happy range. Thanks again.


Thank you Terry for your as usual succinct informative post😊. Do you use annnny kind of artificial sweeteners?


Once or twice per week, I’ll sprinkle half a packet of a stevia blend (erythritol and rabania, from the stevia family) onto the berries atop a chia pudding. It’s the Signature brand sold at Safeway. The packet weighs two grams. I use about 1 gram.


I don’t add any sweetness real or fake. It is not something I am interested in becoming addicted too. My thought, life without sweet stuff. ))
Makes sense for a T2


Hi Terry. Thanks so much for your answer. OK, next fear…Kidneys are functioning at 87% which is stage 2 CKD. Do you have kidney disease? Do you account for that in protein intake?


@Kimball1 I’ve had nephropathy for 23 years, the majority of which I treated with multiple meds for elevated BP, as well as a low protein / low salt diet.

That was until 8 months ago, when I went full-on keto (under 20 grams / day carbs).

In addition to unbelievable BG control (A1C 4.7 with zero hypoglycemic events), my BP is now normal and I no longer take any of the 4 BP meds I lived on. Inflammatory processes (of which I have several) have virtually disappeared.

I do have to watch my total protein intake (I try to keep it < 50 grams) as I’ve lost 35 lbs and weigh in at about 140lbs soaking wet. 70-80% of my daily calories come from healthy fats. Saturated fats are your friend, but use caution when combined with protein. I find my insulin resistance is noticeably higher when my protein intake exceeds 40 grams and I add 50 or 60 grams of fat on top of that.

My daily caloric intake is under 800 calories.

I hope you consider giving this a try